The Analysis Of Related Factors Of Degenerative Changes Of Lumbar Intervertebral Disc In The Young And Middle-aged

Objectives: Through retrospective analysis of young people with lumbar disc degeneration recognized by MRI in our hospital,we explored the influencing factors of lumbar intervertebral disc degeneration in young people.The correlation between the occurrence,symptom manifestations and the number of degenerative segments of lumbar disc degeneration with the population characteristics,living habits indexes and spine-pelvis parameters were analyzed.This study was aimed at providing reference and basis for clinical diagnosis and treatment of lumbar disc degeneration in young people.Methods: Retrospective analysis of the 20-44 years old young people who were admitted to our hospital from January 20 to February 2019,according to whether the lumbar disc is degenerated via the lumbar disc MRI,the young people were divided into normal control group(group A)and lumbar degenerative group(group B).The normal control group(group A)was people with normal lumbar intervertebral discs with grade III-V measured by MRI-enhanced lumbar intervertebral disc MRI imaging grade(Pearce grade).The lumbar degenerative group(group B)was people with grade III-V measured by Pearce grade.According to clinical symptoms and VAS score,the lumbar degenerative group(group B)was classified as lumbar disc degeneration without symptoms group(group B1)and lumbar disc degeneration with symptom group(group B2).According to the number of segments of lumbar disc degeneration,the lumbar degenerative group(group B)was divided into single segment degeneration group(group B3)and multi-segment degeneration group(group B4).All relevant information including gender,age,ethnicity,BMI,whether drinking,smoking,sedentary,heavy physical labor were collected.The image analysis software was used to analyze the T2 WI value of lumbar intervertebral disc pressure in the L3-S1 segment of all patients with lumbar disc MRI;spinal pelvic parameters such included pelvic incidence(PI),sacral slope(SS),pelvic tilt angle(PT),lumbar lordosis(LL),intervertebral space height,L5 incidence(L5I),lumbosacral lordosis angle(LSLA),sacral tilt(ST),lumbar lordosis and lumbar lordosis index were measured. Research content: 1.The characteristics of young people with lumbar disc degeneration and the factors affecting the lumbar disc degeneration were analyzed.2.The T2 WI values in lumbar disc MRI were measured and their consistency with intervertebral space height and Pearce classification were evaluated.3.The factors may affect the presence of corresponding symptoms of lumbar disc degeneration in young people were analyzed.4.The factors may affect lumbar disc degeneration with single-segment or multi-segment in young people were analyzed.Results: 1.A total of 69 cases of young people were enrolled in the study,including 21 cases in the normal control group(group A)and 48 cases in the lumbar disc degeneration group(group B).The number of I-V grades was 67,45,33,22,40,respectively,according to Pearce classification.Discs in the normal control group(group A)were all I-II grade,while in the lumbar disc degeneration group(group B),68.14% of lumbar discs have degenerative change(grade III-V),and mainly located at L4/5 and L5/S1 segment,and the difference was statistically significant.2.The T2W1 value of lumbar disc in the young people was significantly negatively correlated with the Pearce grade.There was no significant difference observed between grade I and grade II,but the T2W1 value significantly decreased after grade III compared with grade I.There was a negative correlation between the height of the intervertebral space and the Pearce classification,but the difference was not significant.3.Compared with the normal control group(group A),the risk factors affecting the degeneration of lumbar disc in young people including long-term sedentary,long-term smoking,high body mass index(BMI),lower rate of lumbar lordosis(LL),lower pelvic angle of incidence(PI)and sacral tilt angle(SS).4.In the lumbar degenerative group,23 patients were degenerative asymptomatic group and 25 patients were degenerative symptom group.Compared with the degenerative asymptomatic group(B1 group),the risk factors with statistically significant and affecting the symptoms of young people with lumbar disc degeneration including long-term sedentary,high body mass index(BMI),and reduced pelvic tilt angle(PT)and disc degeneration of L4/5,L5/S1.5.In the lumbar degenerative group,16 patients underwent single-segment degeneration and 32 patients underwent multi-segment degeneration.Compared with the single-segment degeneration group(B3 group),the risk factors affecting the multi-segment lumbar disc degeneration including smoking,dip angle(ST)reduction,tibial tilt angle(SS)increase.And the VAS score of the multi-segment degeneration group was significantly higher than that of the single-segment degeneration group.Conclusions: The MRI T2W1 value of the lumbar intervertebral disc can directly reflect the extent of lumbar disc degeneration.Lumbar disc degeneration in young people mainly occurs in L4/5 and L5/S1 segment,and 2/3 is multi-segment lumbar disc degeneration.There is a close correlation between the long-term sedentary,long-term smoking,high weight index(BMI)and changes in spinal pelvic parameters with the occurrence,symptom and degree of lumbar disc degeneration in young people.Changes in spinal pelvic parameters may provide some reference for evaluating and predicting the degeneration and progression of lumbar discs in young people.